California School Immunization Record: Vaccines and Exemptions

A California school immunization record is the document a parent or guardian gives the school to prove a child has received the vaccines state law requires before attending. Every public and private school in California, from transitional kindergarten through 12th grade, must collect this record for every enrolled student, and the same rule applies to childcare centers, preschools, nursery schools, and family day care homes.¹ Without an acceptable record, or a valid medical exemption, a child cannot be unconditionally admitted.

What Counts as a Valid Immunization Record

A personal immunization record is accepted by a California school only if it contains four pieces of information:²

The child’s name and date of birth
The type of vaccine received
The exact date (month, day, and year) each dose was given
The name of the physician or clinic that administered the vaccine

Several document formats meet this standard. The most common is the yellow California Immunization Record card handed to parents by a doctor’s office. An official printout from a medical provider works. So does a record accessed through the California Immunization Registry (CAIR). Records from other states and other countries are acceptable as long as they contain the required details.²

Once the school receives the personal record, staff transfer that information onto the California Pre-Kindergarten and School Immunization Record, commonly called the Blue Card or CSIR form. Schools may also use equivalent written or electronic formats.³ Parents keep the original personal record; the school keeps its own copy in the student’s file.

Required Vaccines for TK Through 12th Grade

The record must show the following vaccinations for any student entering transitional kindergarten through 12th grade:⁴

DTaP (diphtheria, tetanus, and pertussis): 5 doses. Four doses are acceptable if one was given on or after the child’s 4th birthday, and three doses are acceptable if one was given on or after the 7th birthday.
Polio: 4 doses. Three doses are acceptable if one was given on or after the 4th birthday. Oral polio vaccine doses given on or after April 1, 2016, do not count.
Hepatitis B: 3 doses. Required at admission to any grade except 7th grade.
MMR (measles, mumps, and rubella): 2 doses, both given on or after the child’s 1st birthday.
Varicella (chickenpox): 2 doses.

These requirements apply equally to public and private schools.⁵ The reduced-dose allowances matter in practice: a polio dose after age four can bring the total needed down from four to three, for example. Ask your child’s pediatrician whether any of the reduced-dose rules apply before scheduling extra appointments.

The Extra 7th Grade Booster

Students advancing to 7th grade need one additional vaccine on top of the K-12 list: a Tdap booster (tetanus, diphtheria, and pertussis) given on or after the child’s 7th birthday.⁴ It is typically given around age 11. Without documentation of this dose, a student cannot be unconditionally admitted to 7th grade.⁶ Hepatitis B is not required at the 7th-grade checkpoint if the student was previously admitted at an earlier grade.⁷

Childcare and Preschool

Children entering childcare, preschool, or another pre-kindergarten program are held to requirements that scale with age at admission and add Hib (Haemophilus influenzae type b):⁸

2 through 3 months: 1 Polio, 1 DTaP, 1 Hep B, 1 Hib
4 through 5 months: 2 Polio, 2 DTaP, 2 Hep B, 2 Hib
6 through 14 months: 2 Polio, 3 DTaP, 2 Hep B, 2 Hib
15 through 17 months: 3 Polio, 3 DTaP, 2 Hep B, 1 Varicella, and (on or after the 1st birthday) 1 Hib and 1 MMR
18 months through 5 years: 3 Polio, 4 DTaP, 3 Hep B, 1 Varicella, and (on or after the 1st birthday) 1 Hib and 1 MMR

One Hib dose must be given on or after the child’s first birthday regardless of how many earlier doses were received, and Hib is only required for children under five.⁸ For pre-kindergarten, only inactivated polio vaccine (IPV) counts; oral polio vaccine does not.

Submitting the Record to the School

Give the immunization documentation to school or childcare staff at registration, or before the first day of attendance if registration happens earlier. A school nurse or trained administrator reviews the record and decides whether the child qualifies for unconditional admission, conditional admission, or must be excluded until required doses are completed.⁹ Every school and pre-kindergarten facility in California is legally required to enforce these requirements, maintain records for every enrolled child, and file annual reports with the state.¹

When the Record Is Incomplete

A child who has started a required vaccine series but has not completed it can still attend school under conditional admission, provided the child is not currently due for any dose at the time of enrollment. The school must give the parent written notice of the dates by which the remaining doses need to be completed.¹⁰

Conditional admission is not passive. Schools review the file of each conditionally admitted student at least every 30 days, notify the parent of remaining doses, and update the immunization file.¹⁰ If the next required dose is not received by the deadline, the school must exclude the child from further attendance until it is.¹¹ Mark the dose deadlines on your calendar and book appointments well in advance.

Transfers From Other States or Countries

Students transferring in from another state at any grade from kindergarten through 12 get a temporary grace period. If the new school does not yet have the immunization record when the student arrives, the school may allow attendance for up to 30 school days while records are obtained. If nothing has arrived by the end of that period, the school must exclude the student until the parent provides documentation.¹⁰

Children entering from another country face stricter rules, with no grace period. Schools are instructed to obtain records from the parents immediately rather than wait for records from the previous country. If the family has no personal records, if doses are missing, or if the foreign records are in a language the school cannot read, the school refers the family to their physician or the local health department. CDPH provides a reference list of foreign vaccine names to help schools interpret international records.²

If You Cannot Find Your Child’s Record

Lost records are common, especially after a move or a change of doctors. California offers several ways to track down existing documentation:¹²

The state’s Digital Vaccine Record portal, which pulls from the California Immunization Registry (CAIR).¹³
The doctor’s office or clinic that gave the vaccines. If shots came from more than one provider, call each one.
Previous schools your child attended, which are required to keep immunization records on file.
Pharmacies, if any doses were given there.
Family records such as baby books.

If no documentation can be located, your child’s doctor can decide what is needed and, when appropriate, restart the series. In some cases a blood test (a titer) can confirm immunity to certain diseases without repeating vaccines. CDPH recognizes serologic evidence of immunity for diseases such as measles, mumps, rubella, and varicella in some settings; discuss the option with the school and physician.

Medical Exemptions

A medical exemption is the only way to enroll without meeting the vaccine requirements. California eliminated personal belief exemptions, and there is no religious or philosophical opt-out.¹⁴

To obtain a medical exemption, a licensed physician (MD or DO) must examine the child and determine that a specific vaccine is medically unsafe for that child. Since January 1, 2021, the only medical exemption schools may accept is the standardized electronic form processed through the California Immunization Registry – Medical Exemption (CAIR-ME) system.¹⁵

The parent registers for a CAIR-ME account, completes the required fields, and receives a Medical Exemption Request Number. The parent gives that number to the child’s doctor, who logs in to CAIR-ME, enters the medical information, and issues the exemption.¹⁶ Each vaccine being exempted must be listed separately with the medical basis for each one.¹⁵

Exemptions can be permanent or temporary. A temporary exemption cannot exceed one year, and no exemption of any kind extends beyond the child’s current grade span (birth to preschool, kindergarten through 6th grade, or 7th through 12th grade).¹⁵

When Immunization Rules Do Not Apply

California’s immunization requirements do not apply to students enrolled in a home-based private school or an independent study program that does not involve classroom-based instruction.⁵ If a home-schooled student later enrolls in a traditional school, all requirements apply at that point.

Help Paying for Required Vaccines

The federal Vaccines for Children (VFC) program provides vaccines at no charge to children under 19 who are uninsured, enrolled in Medicaid, American Indian or Alaska Native, or underinsured (meaning their health insurance does not cover vaccines or charges copays for them). Underinsured children can receive VFC vaccines at Federally Qualified Health Centers and Rural Health Clinics.¹⁷ Children enrolled in a separate CHIP program are considered insured and do not qualify for VFC. Local health departments across California also run low-cost or free immunization clinics.

1
California Department of Public Health. California School Immunization Law
2
California Department of Public Health. California Immunization Handbook
3
California Department of Public Health. California Pre-Kindergarten and School Immunization Record
4
California Department of Public Health. California School Immunization Record Requirements
5
California Legislative Information. California Health and Safety Code 120335
6
California Department of Public Health. 7th Grade Immunization Assessment Instructions
7
California Legislative Information. California Health and Safety Code 120325-120335
8
California Department of Public Health. Shots Required for Child Care/Preschool
9
Legal Information Institute. California Code of Regulations 17 CCR 6025 – Unconditional Admission
10
Legal Information Institute. California Code of Regulations 17 CCR 6035 – Conditional Admission
11
California Legislative Information. California Health and Safety Code 120375
12
California Department of Public Health. Where to Get Immunized and Find Records
13
California Department of Public Health. California Immunization Registry
14
California Legislative Information. California Health and Safety Code 120370
15
California Legislative Information. California Health and Safety Code 120372
16
California Department of Public Health. California Immunization Registry Medical Exemption IMM-1363 Instructions
17
Centers for Disease Control and Prevention. Vaccines for Children (VFC) Program Eligibility